A Philadelphia jury on Monday convicted abortion doctor Kermit Gosnell on three counts of murder and one count of involuntary manslaughter in the deaths of three babies and one adult patient at his inner-city clinic. The case, which revealed horrific conditions at Gosnell’s practice as well as gruesome details about the illegal operations he performed there, became a flashpoint in the national debate about abortion. While his sentence is not yet decided–jurors will reconvene on May 21 to consider whether Gosnell should be executed–there are lessons to draw from his trial, its coverage and the outcome.

This was not a case about the morality of legal, late-term abortion. Gosnell’s trial was about illegal abortion and homicide. The methods Gosnell used to end the lives of the babies cited in the case against him—including snipping their necks with scissors after they were outside the womb—are medically indefensible by any measure, in any case. Prochoice advocates did not defend Gosnell or argue that the gruesome practices in his clinic were part of the sad, but real, world of legal abortion in the U.S. On the contrary, many abortion rights activists long ago called for Gosnell to be convicted of murder.

Gosnell was accused of falsifying medical records to make it appear as though the babies aborted in his clinic were all under the legal limit for abortion in Pennsylvania, which is 24 weeks of gestation, about the age many babies can survive on their own outside the womb. But even legally performing abortions this late in pregnancy is extremely rare. While some anti-abortion activists claim that the horror of Gosnell’s case reflects a widespread problem of under-regulated late-term abortion providers, according to the the Guttmacher Institute, a reproductive rights organization often cited by those on both sides of the abortion debate, less than 2% of all abortions in the U.S. occur after 21 weeks of pregnancy. Some 80% take place before 10 weeks.

State regulation is where the action is on abortion. By all counts, Pennsylvania state regulators failed spectacularly in the Kermit Gosnell case. Authorities neglected to properly and consistently inspect Gosnell’s clinic and at least two top health officials were fired in the wake of the scandal. Pro-life state legislators across the country in recent years have been successfully pushing for additional state regulations governing the architecture and operation of abortion clinics. The Pennsylvania case will be a boon for this effort; pro-life activists will no doubt argue that more regulations will prevent the next Kermit Gosnell. But, as abortion rights activists point out, many of the new modern state regulations for abortion clinics do not objectively improve safety. The goal of these new laws, in many cases, appears to be to regulate abortion providers out of business. As TIME reported in a recent cover story:

[Pro-life activists’] ultimate goal is to land another abortion case before a sympathetic Supreme Court in an attempt to overturn Roe. Along the way, in what Charmaine Yoest, president of the antiabortion group Americans United for Life, describes as a strategy to “work around Roe,” pro-life activists hope to severely–or completely–curtail access to abortion at the state level.

In Mississippi, pro-life activists pushed for passage of a 2012 law requiring that doctors who perform abortions have admitting privileges at local hospitals. None of the out-of-state physicians who perform abortions at the state’s sole abortion clinic have these privileges…Governor Phil Bryant, who signed the law, said it was part of an effort to “end abortion in Mississippi.”

The Volunteer Women’s Medical Clinic in Knoxville, Tenn., was open for 38 years before it closed in August 2012, citing the state’s Life Defense Act, passed earlier in the year, which also requires doctors to have hospital admitting privileges. A doctor who worked at the facility obtained hospital privileges but died suddenly of a stroke, and clinic director Deb Walsh said she couldn’t afford to keep her doors open while she tried to replace him.

In Virginia, the state board of health adopted a rule last year requiring abortion clinics to comply with architectural zoning regulations for hospitals. Like the Mississippi law and one just enacted in Michigan requiring abortion clinics to be licensed, the Virginia rule seems designed to make clinics safer, but there is little evidence that women’s health had previously been in danger.

In Gosnell’s case, regulators failed to enforce existing laws that, if applied, might have prevented the horrors that occurred in his clinic.

While it wasn’t completely ignored, the Gosnell trial revealed the mainstream media’s hesitancy to swarm a story about a horrifying abortion-related crime. Philadelphia news outlets did an exemplary job of covering the Gosnell trial, but the national media did not. Two years after outlets like the Associated Press and the New York Times covered Gosnell’s arrest and a judge issued a preliminary gag order on his trial, few representatives from the mainstream media showed up to cover the testimony in early 2013. (In contrast, cases like the murder of abortion provider George Tiller remained in the public eye for their duration.) Conservative activists interpreted this aloofness as evidence of pro-choice bias and pressured major outlets to cover the story more aggressively. “This should be front page news,” Kirsten Powers wrote in a USA Today op-ed. “The deafening silence of too much of the media, once a force for justice in America, is a disgrace.”

Some reporters initially shrugged off this criticism—one health care writer publicly dismissed the case as a “local crime story” —but most outlets corrected course, and devoted more attention to the trial. Part of the media’s hesitation probably did have to do with politics; it’s no secret that most journalists are socially liberal. But a more powerful explanation might have to do with the extremely disturbing nature of the crime and its proximity to issues—abortion, poverty and race—that Americans are often uncomfortable discussing. Kidnapping and terrorism are tabloid fodder, but the grisly details of the Gosnell case are revulsive to even the most desensitized rubbernecker.